医学
类风湿性关节炎
队列
队列研究
内科学
前瞻性队列研究
体质指数
风险因素
关节炎
比例危险模型
危险系数
优势比
置信区间
作者
Nathalie E Marchand,Jeffrey A. Sparks,Susan Malspeis,Kazuki Yoshida,Lauren C. Prisco,Xuehong Zhang,Karen H. Costenbader,Frank B. Hu,Elizabeth W. Karlson,Bing Lu
出处
期刊:Rheumatology
[Oxford University Press]
日期:2021-07-10
被引量:1
标识
DOI:10.1093/rheumatology/keab535
摘要
OBJECTIVE To examine the association of long-term weight change with rheumatoid arthritis (RA) risk in a large prospective cohort study. METHODS The Nurses' Health Study (NHS) II started in 1989 (baseline); after exclusions, we studied 108,505 women 25-42 years old without RA. Incident RA was reported by participant and confirmed by medical record review. Body weight was reported biennially through 2015. We investigated two time-varying exposures: weight changes from baseline and from age 18; change was divided into 5 categories. We used a marginal structural model (MSM) approach to account for time-varying weight change and covariates. RESULTS Over 2,583,266 person-years, with a median follow-up time of 25.3 years, 541 women developed RA. Compared to women with stable weight from baseline, weight change was significantly associated with increased RA risk [weight gain 2- 2 kg: RR = 2.05 (95% CI 1.28, 3.28)]. Weight gain of 10 kg or more from age 18 compared with stable weight was also associated with increased RA risk [10-< 20 kg: RR = 2.12 (95% CI 1.37, 3.27), ≥20 kg: RR = 2.31 (95% CI 1.50, 3.56)]. Consistent findings were observed for seropositive and seronegative RA. CONCLUSION Long-term weight gain was strongly associated with increased RA risk in women, with weight gain of ≥ 20 kg associated with more than a three-fold increased RA risk. Maintenance of healthy weight may be a strategy to prevent or delay RA.
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